Selection of Patients for Coronary Angiography and Coronary Revascularization Early after Myocardial Infarction: Is There Evidence for a Gender Bias?

Abstract

▪ Objective: To determine whether a gender bias exists in the selection of patients for diagnostic and therapeutic cardiovascular procedures early after myocardial infarction. ▪ Design: A retrospective cohort study. ▪ Setting: A community-based tertiary care teaching hospital. ▪ Patients: A total of 2473 consecutive patients with a principal discharge diagnosis of acute myocardial infarction and a peak creatine kinase MB fraction of at least 4%. ▪ Measurements: Comparison of men and women regarding the frequency with which they underwent various cardiac procedures. ▪ Results: Women had coronary angiography during hospitalization for myocardial infarction much less frequently than men (odds ratio, 0.55; 95% Cl, 0.46 to 0.65), but the age-adjusted rates were similar in women and men (odds ratio, 0.91; Cl, 0.75 to 1.12). An abnormal ejection fraction (Conclusions: No evidence of a difference in the rate of coronary angiography early after myocardial infarction between women and men was found after age adjustment. Among patients who have cardiac catheterization early after myocardial infarction, women and men are equally likely to have angioplasty, but women are less likely than men to have coronary artery bypass surgery.